skip to main content

Atopic Eczema — SCE Dermatology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateInflammatory DermatosesAtopic EczemaSCE Dermatology

A 35-year-old woman with severe eczema has not responded to multiple systemic therapies. She asks about the role of allergen immunotherapy (desensitisation) for house dust mite in atopic eczema. What does current evidence support?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Limited and conflicting evidence — sublingual or subcutaneous immunotherapy to house dust mite may have modest benefit in selected patients with HDM-sensitised AD but is not routinely recommended

Allergen immunotherapy (AIT) for house dust mite (HDM) in atopic eczema has been investigated in several clinical trials with conflicting results. Some studies show modest improvement in SCORAD/EASI in HDM-sensitised AD patients, but the evidence is insufficient to recommend routine use. BAD and NICE do not currently recommend AIT as standard treatment for AD. It remains experimental and may be considered in highly selected patients (clear HDM sensitisation with clinical correlation, failed standard therapy) within a specialist setting. AIT is well-established for HDM-induced allergic rhinitis and asthma but the evidence for eczema is weaker. Further RCTs are needed.

Reference: BAD 2020 AD Guidelines; EAACI 2020